Senior Workers' Compensation Claims Representative

Acadia Insurance (a Berkley Company); City of Syracuse (NY); On-site; USD 90,000 - 105,000; Full time

Benefits offered by this job

Base salary 90k–105k

Annual discretionary bonus

Comprehensive benefits

Job summary

Acadia Insurance, part of the W.R. Berkley family, is seeking a Senior Workers’ Compensation Claims Representative in New York. The role involves investigating and resolving complex workers’ compensation claims across NH/ME/VT/NY with emphasis on negotiation and proper reserves.

Requires a Bachelor’s degree and at least five years’ claims experience, strong communication skills, and a valid driver’s license. Competitive base salary with comprehensive benefits. Sponsorship not offered.

Qualifications

• Five years of New Hampshire and/or Maine Workers’ Compensation Lost Time claims handling experience or experience with VT or NY claims.
• Excellent organizational skills and ability to prioritize multiple tasks.
• Strong negotiation and claims resolution skills.
• Proficient with multi-faceted systems and strong computer skills.
• Excellent written and verbal communication; able to relate to agents and departments.

Responsibilities

• Investigate, evaluate and resolve workers’ compensation claims per company standards and state rules.
• Analyze facts of loss and communicate compensability decisions.
• Prepare professional written communications to insureds, claimants, attorneys and agents.
• Conduct thorough investigations and witness interviews when needed.
• Negotiate settlements and manage litigated files with defense counsel as appropriate.
• Maintain documentation in a paperless claims system and produce detailed reports.

Skills

Claims handling

Negotiation

Organization

Communication

MS Word & Excel

Driver's License

Insurance coursework

Education

Bachelor’s degree

Tools

MS Word

Excel

Job description

Company Details

Acadia Insurance is a regional property casualty insurer with offices throughout the Northeast. As a member of W.R. Berkley Corporation (NYSE: WRB), one of the largest property casualty insurance holding companies in the United States, our financial strength and integrity are two of the main reasons why Independent Agents place business with us. Acadia is rated A+ (Superior) by A.M. Best, with an A+ claim paying ability rating by Standard & Poor’s.

At Acadia, we value our employees, our customers and our communities. Employees at Acadia are part of a progressive company where everyone can make a difference. We promote an inclusive environment which encourages continuous learning and the chance to grow and develop.

Company URL: https://www.acadiainsurance.com/

Responsibilities

The Senior Workers’ Compensation Claims Representative is responsible for investigating, evaluating, and resolving assigned workers’ compensation claims in accordance with company standards, procedures, and state regulatory requirements.

• Investigate, evaluate and resolve claims in accordance with company standards, procedures, and state regulatory requirements.
• Analyze and determine specific facts of loss to reach appropriate decisions and effectively communicate the company’s compensability decisions.
• Compose a variety of written communications to insureds, claimants, attorneys and agents in a professional and error-free manner.
• Conduct detailed, comprehensive claim investigations including possible on-site scene examinations and in-person witness interviews when appropriate and necessary.
• Evaluate and document exposure to ensure accurate and timely reserves; immediately elevate to management cases with significant exposure.
• Negotiate effectively and in good faith to achieve fair and accurate claim settlements.
• Proactively manage litigated claim files from inception to closure, including collaboration with defense counsel to determine and execute an appropriate plan of action; bring litigated cases to resolution either by negotiated settlement or hearing decisions, as appropriate.
• Retain vendors to achieve appropriate claim outcomes while remaining mindful of loss adjustment expenses.
• Manage assigned workloads effectively to achieve quality and quantity production goals while providing superior customer service.
• Effectively present cases in roundtable discussions with peers and members of management at all levels.
• Appropriately and clearly document all notes and file activity in a paperless claim system; compose detailed periodic reports including claim summary reports and large loss notifications.
• Communicate with other departments regarding developments on specific claim files as well as overall claim trends relevant to Acadia’s business.
• Maintain a strong relationship and frequent communication with Acadia’s agency partners.
• Work proficiently with various computer programs including MS Word, Excel, and other applications used in the claim handling process.
• Attend internal and external seminars and other training events and provide feedback to peers and/or members of management.
• Obtain all required state adjuster licenses and maintain them as needed by complying with continuing education requirements.
• Pursuit of industry-related professional designations is encouraged.
• Perform other duties as assigned.

Qualifications

• 5 years of New Hampshire and/or Maine Workers’ Compensation Lost Time claims handling experience or Experience with VT or NY claims.
• Excellent organizational skills with the ability to handle multiple tasks and effectively prioritize workload.
• Demonstrated depth in negotiation and claims resolution skills.
• Strong computer skills and ability to work with multi-faceted systems.
• Ability to effectively and independently manage a complex workload while exhibiting very sound judgment.
• Excellent written and verbal communication skills.
• Demonstrated ability to develop and maintain relationships with agents and other departments while exemplifying superior teamwork.
• Advanced professional insurance coursework (i.e., AIC, CPCU) or completion of other insurance-related classes is preferred.
• Valid Driver’s License is required.
• The Company is an equal employment opportunity employer.

Education Requirement

• Bachelor’s degree (B.A.) and a minimum of 5 years of related experience and/or training, or an equivalent combination of education and experience.

Additional Company Details

We do not accept unsolicited resumes from third party recruiting agencies or firms.

The company offers a competitive compensation plan and robust benefits package for full time regular employees including:

• Base Salary Range: 90k-$105k
• Eligible to participate in annual discretionary bonus
• Benefits include: Health, dental, vision, dental, life, disability, wellness, paid time off, 401(k) and profit‑sharing plans

The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.

Sponsorship Details

Sponsorship not Offered for this Role